Provider Demographics
NPI:1558596387
Name:BROWN, HEATHER MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:BURROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:626 S DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2544
Mailing Address - Country:US
Mailing Address - Phone:812-841-3372
Mailing Address - Fax:
Practice Address - Street 1:3325 N ARLINGTON HEIGHTS RD STE 400B
Practice Address - Street 2:STE 1127
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1583
Practice Address - Country:US
Practice Address - Phone:812-841-3372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007655103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL589170Medicare PIN